NHS managers are on the whole such a bunch of conniving, swindling, privatising, meddling, paper-pushing numbskulls that one might be tempted to think that Labour Party officials were in charge of appointing them, all the better to destroy the NHS.

So here, hidden away from the main news rags, is yet another example, with some interpollations from me, because even the Manchester Evening News doesn't have it all straight:

Patients forced to move
Amanda Crook
29/ 8/2007

SERIOUSLY ill psychiatric patients have been bussed more than 100 miles to other units ahead of a massive strike by nurses.

Most of them have been sectioned because they are considered a risk to themselves or others and suffer from conditions such as schizophrenia, manic depression and dementia.

But health bosses have opted to close three wards and move patients from the Park House unit at North Manchester General while health workers take part in a three day walkout. Staff are protesting at the suspension of union official Karen Reissmann, a senior psychiatric nurse who has worked in Manchester for 25 years and has led opposition to a controversial review of care.

Just to be clear on this, the staff are not protesting against any managerial investigation or disciplining of this nurse, they are protesting at her suspension prior to investigation. The charges against her do not relate to patient care, and her competence is not in question, therefore there is no reason to suspend her.

Over five hours yesterday afternoon it is understood that 21 patients were moved by bus to Darlington and a further 15 by cab to Bury. Thirty were sent home.

In past strikes - in line with NHS practice during industrial action - union leaders in talks with bosses have agreed to allow essential staff to remain on duty to care for the sickest patients along with managers and agency staff. But on this occasion bosses said all hospital staff were needed and negotiations collapsed.

Which is obviously what the managers wanted. In effect, they were trying to deny Unison members the right to strike: a right which no nurse abuses.

It has cost Manchester Mental Health and Social Care Trust (MMHSCT) an estimated £36,000 for the patients’ care in other hospitals. The trust is already in special financial measures with a predicted debt of £2.5m.

Both sides today agreed patients were suffering as a result of the dispute but blamed the other for the stalemate.

Nurses were said to be devastated at the impact on their patients and insisted it was not necessary to close wards because they would have made sure enough staff did not strike in order to keep them open.

And it is worth emphasising that in previous disputes they have done this.

Unrest
Almost 90 per cent of Unison workers who took part in the ballot voted to walkout at 7am today until midnight on Friday. The unrest happened after trust bosses charged Ms Reissman with bringing the trust’s reputation into disrepute 10 weeks ago. She is accused of behaviour undermining their confidence in her as an employee; and misusing her time as a community psychiatric nurse. She has been an outspoken critic of proposed staff cuts at the trust and the transfer of NHS services to the voluntary sector.

She has good reason to speak out too. Instead of cutting managerial jollies or posts, Trust management has decided to scrap patient services: services which are already ranked as third worst in the country. As a result of the ongoing rows about further proposed cuts (called 'Change in Mind' by managers - 'Mindless Change' by staff), the medical director (Frank Margison) has resigned, and a patients' group is calling for a public enquiry into the Trust management.

Not surprising really. The proposals for community mental healthcare include plans to change a 24/7, 365 days a year service into a 9 to 5 weekdays only one. We're talking here about the most vulnerable members of society: the severely mentally ill. 'Out of hours' they will be expected to go to A and E departments if they relapse or have a crisis. They either won't bother, or will go and end up in a worse state than before - possibly in a prison cell, since pressurised A and E staff rarely have the time or skills to treat the severely mentally ill with the kid gloves they require.

Last night Stephanie Thomas regional head of health for Unison said: “We are disgusted at the way the trust has chosen to deal with this, we have been in constant contact with the trust to try to arrange emergency cover, we were ready to do this until 3pm yesterday.

“We believe the trust’s action have not only put patients at risk but also members of the community – we would ask for the trust’s action over the last few days to be fully investigated.”

“This decision will have a long term impact on industrial relations with the trust which were just starting to improve – it has only made staff more determined to take action in support of Karen."

MMHSCT chief executive, Sheila Foley said “Our first priority is and always will be patient care. It is deplorable that Unison has decided not to provide an adequate level of cover for these acutely ill patients therefore we have had no option but to seek care for them elsewhere.

“We understand the disruption and upset that may be experienced by our patients and carers as a result of this strike action.”

Understand and don't care.

Sheila Foley, of all people, should be aware of the need for strong community services for the mentally ill. She was Chief Executive of East London and the City Mental Health NHS Trust, the Trust that was caring for Peter Bryan when he killed and tried to eat Brian Cherry in 2004.

Yesterday staff were given one hour to get in-patients on three wards ready to move, some to private units where the usual cost is £350 per person, per night.

MMHSCT has units at North Manchester General, Manchester Royal Infirmary and Wythenshawe hospitals as well as providing community care across the city.

Impact

Patients have not been moved from MRI and Wythenshawe because the strike is expected to have more impact at North Manchester as this is where Ms Reissmann was based.

Ms Reissman said: “Unison has made every effort to come to arrangements with the trust but they were not interested, they asked for all staff who work on the wards to be exempt and they have not been prepared to negotiate with us.

“We have provided safe cover for patients during industrial disputes previously and we were happy to do this again, there was no need for patients to be bussed across the country or to leave them at home without community support.”

Unison leaders estimate 600 of the trust’s 1,500 staff are expected to join the walkout.

Trust bosses refused to confirm how much the arrangements would cost, saying some of the rates were still being negotiated, and insisting patient safety had to come above financial concerns.

Shame those priorities only hold true during strikes.

They also confirmed they would provide transport for relatives to visit patients in the units.

Alan Hartman from patient group Manchester User Network said: “We are very worried about this last minute decision to bus patients all over the country it is unprecedented, we have never seen anything like this.

“Some patients don’t even know what the arrangements are for them getting medication. We also have carers worrying themselves sick and asking for advice. We support the nurses who have been sticking up for patients and their jobs have been under threat, they have just been pushed too far.”

When relationships between managment and staff break down to this extent, it is a sign of complete managerial incompetency and arrogance. These people need replacing and soon.

What has been most worrying to me about this case (and to a lesser extent the prison officers' strike) is that what pitiful coverage there has been has mostly centred on attacking nurses for striking. The media seems happy for public sector workers to have the right to strike so long as they don't use it under any circumstances.

Personally, I think that all the health unions have been pussyfooting around for too long, ever since Thatcher started the managerialisation (is that a word?!) in the 80s. Since then, every reform seems to result in more managers and more spending on monitoring fewer and fewer staff providing fewer and fewer services. Of course, the fiddled figures hide this. Got a long waiting list for hernia repair? Want to meet your government imposed 8-week waiting time for all surgeries? Just decide that hernia repairs are not clinically warranted and cancel them all! Simple!

No wonder there's so many managers. Gotta be hard work spinning so fast.